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General NPI Number Information
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NPI Number | 1508974940
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Entity Type | Organization
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Legal Business Name | PEDIATRIC ASSOCIATES OF WINCHESTER
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Dates
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Enumeration Date | 08/27/2006
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 1002 AMHERST ST BLDG C
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City | WINCHESTER
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State | VA
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Zip | 22601-3323
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Country | US
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Telephone | 540-662-3853
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Fax | 540-662-0336
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Provider Business Mailing Address
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Address Line | 1002 AMHERST ST BLDG C
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City | WINCHESTER
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State | VA
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Zip | 22601-3323
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Country | US
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Telephone | 540-662-3853
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Fax | 540-662-0336
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Authorized Official
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Title or Position | INSURANCE COORDINATOR/ACCTS RECEIVA
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Name | BRIDGET DENISE GIBSON
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Credential |
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Telephone | 540-662-3853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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